Shoulder Pain? Or Thoracic Spine Issue?

Image of increased trunk flexion vs. trunk extension and how it impacts shoulder flexion
What is it?

Have shoulder pain when you raise overhead? Been doing shoulder exercises with minimal success? Maybe… it is not your shoulder. Your upper back (thoracic spine) must go into extension for end range shoulder flexion. Restrictions in this area of the body can lead to impingement or compression of the structures in the shoulder. Which can be painful and potentially lead someone to think they have a shoulder issue. 

The Anatomy 

The humerus and shoulder blade create our glenohumeral joint. The shoulder blade sits on the backside of the ribs and work in unison with the thoracic spine. To lift your arm overhead you need both the glenohumeral joint and scapulothoracic joint simultaneously. You may not realize you are doing it but the brain is moving these joints in unison to achieve your desired motion. See the joints in the image below on the right.

The Mechanics

There is a limited amount of space in all of our joints. Neighboring joints can cause you to lose or gain motion depending on their position. Try out this example in the picture above. Round your upper back and hunch forward. Try and raise your arms up. Note any restrictions, pain, or decrease in motion? Now, sit up nice and tall and repeat. See the difference? When your thoracic spine is flexed or hunched forward it can bring your shoulder blade along for the ride. This will limit the necessary motion needed to help raise the arm overhead. If your thoracic spine is stuck in a position like this, you can cause stress to the glenohumeral joint. Which, may result in impingement down the road.

Scapulothoracic joint issues
What To Do?

When it is not immediately obvious you may need to follow up with a trained professional. Some restrictions in the thoracic spine will require assistance from a PT, Chiropractor, or massage therapist. Many times scare tissue or adhesions form within joint capsules as a protective mechanism. This is the body’s attempt at reinforcing there new normal. Other instances require proper sequencing of the muscles to improve biomechanics. 

Follow Up

Give the above movements a try and see if you can notice any difference in your mobility within the shoulder and upper back. Whether you are a high level athlete or weekend warrior, you can always improve your body’s function and mechanics.

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